Gynecology Doctors Research Articles

A survey of obstetric and gynaecology doctors at an Australian metropolitan tertiary hospital to understand their views, training and confidence in abortion care.

The barriers to comprehensive abortion care in Australian metropolitan tertiary hospitals are under-researched. Previous work has suggested that negative practitioner attitudes and lack of training may play a large role; however, this remains poorly understood. The aim was to survey doctors practicing obstetrics and gynaecology to better understand their views, training experience and confidence in abortion care. The method involved a cross-sectional study via an anonymous survey at a single metropolitan tertiary hospital not providing substantive abortion services in Melbourne, Australia. Inclusion criterion was obstetric and gynaecology medical staff working at that hospital. Data were collected regarding views, training experiences and confidence in first-trimester medical and surgical abortion, and second-trimester surgical abortion. Data were analysed according to levels of training, categorised as RANZCOG (Royal Australian and New Zealand College of Obstetricians and Gynaecologists) Fellows, prevocational/vocational trainees and general practitioner specialists. Sixty-one valid responses were received from 90 eligible participants (response rate 68%). An overwhelming majority (96%) supported abortion services. The majority of RANZCOG Fellows felt confident performing first-trimester surgical abortion (89%) and first-trimester medical abortion (71%); however, only half felt confident performing second-trimester surgical abortion (50%). Prevocational/vocational trainees were overall less confident but overwhelmingly expressed interest in gaining further experience in abortion. Doctors are generally confident in providing first-trimester abortion services (medical or surgical) in the metropolitan tertiary setting. However, further work is required to understand ongoing barriers to comprehensive abortion care. There may also be a skills shortage for second-trimester surgical abortion, requiring significant improvements in abortion training.

GYNECOLOGY AND OBSTETRICS RESIDENTS' KNOWLEDGE OF HORMONAL CONTRACEPTION IN SPECIAL SITUATIONS

Objective: To assess the knowledge of gynecology and obstetrics residents about hormonal contraception in special situations, according to the World Health Organization (WHO) guide Eligibility Criteria for Contraceptive Use. Method: This was a cross-sectional, descriptive study, in which a questionnaire was administered to resident doctors in Gynecology and Obstetrics at the Santa Casa de Misericórdia Foundation in Pará, who were divided according to their year of residency (R1, R2 and R3). Data was collected in a virtual environment using a questionnaire on the Google forms platform. Results: All 57 (100%) of the medical residents participated in the survey, 50 (87.7%) of whom were female, aged between 18 and 29 (61.4%), in their first or second year of residency (35.0% each year). As for the percentage of correct answers per year of residency, it was clear that the first year had the highest rates of correct answers for all contraceptive methods (7.0%), and when analyzing which residents had corrected at least one method in isolation, the second year had the highest number of correct answers (28.0%), although there was no statistical difference in relation to the year of residency and the number of correct answers. When assessing the overall number of correct answers, it was found that the residents were at least aware of some of the main contraceptive methods. Conclusion: The results of this study showed that residents' objective and perceived levels of knowledge regarding the prescription of contraceptives in special situations were insufficient. Thus, the results show the need for medical training when prescribing these drugs.

Implementation of Simulation Training Programs as a Part of Continuing Medical Education of Obstetrics and Gynecology Doctors in Perm Region

As a part of the implementation of the regional program of continuous medical education of obstetrics and gynecology doctors in the Perm region, aimed at reducing maternal and perinatal morbidity and mortality, simulation training programs have been developed. The topics of the programs include algorithms for providing specialized care for emergency conditions, such as severe preeclampsia /eclampsia, obstetric hemorrhage, etc. The implementation of the programs will improve the provision of obstetric and gynecological care in Perm region.

Why don't we follow influencers in obstetrics and gynaecology on Twitter to obtain information on the most recent international congresses?

We proposed following influencers in obstetrics and gynecology on Twitter. We believe that the use of Twitter may help obstetrics and gynecology doctors in low-income countries as well as stimulate fellows and residents by following actual discussions at international conferences.

The kindness COVID-19 toolkit: a mixed-methods evaluation of a programme designed by doctors in training for doctors in training

ObjectivesThe impact of a coronavirus disease (COVID-19)-specific professional development programme on the well-being of obstetrics and gynaecology (O&G) doctors in training (DiT) working during the pandemic.DesignA mixed-method evaluation of a...

COVID-19 Vaccine Acceptance during Pregnancy and Influencing Factors in South Korea.

Pregnant women were excluded from vaccination against Coronavirus 2019 (COVID-19) until September 2021 in South Korea. Although vaccination for pregnant women started in October 2021, vaccine acceptance in pregnant women is yet unknown. This cross-sectional study aimed to investigate COVID-19 vaccine acceptance during pregnancy and influencing factors. An anonymous survey was distributed in obstetrics departments to all pregnant or postpartum women, during the prenatal or postpartum visit. The proportion of self-reported COVID-19 vaccination during pregnancy among 436 women was 26.6%. Pregnancy-related independent factors influencing maternal COVID-19 vaccination were “received vaccine information about from obstetrics and gynecology (OBGYN) doctors” (OR 3.41, 95% CI 2.05–5.65), “cohabitant COVID-19 vaccination” (OR 2.43, 95% CI 1.06–5.59), and “second trimester” (OR 7.35, 95% CI 1.54–35.15). In women who did not want to get vaccinated, the most common reason for COVID-19 vaccination hesitancy was concern that COVID-19 vaccine might affect the fetus (91.7%, 243/266), followed by distrust in COVID-19 vaccine effectiveness (42.6%, 113/266). This study showed that providing information about maternal COVID-19 vaccination, especially by OBGYN doctors, is crucial for increasing vaccination coverage in pregnant women. Providing updated evidence of COVID-19 vaccine efficacy and safety in pregnant women may be also helpful for increasing vaccine acceptance.

Willing but not able: A survey of New Zealand health practitioners' interests in providing second trimester abortion care and the obstacles they face.

In 2020, abortion was removed from the Crimes Act. Abortions under 20 weeks gestation no longer require an indication and criteria for abortion above 20 weeks gestation has broadened. Prior to law reform, all abortions were provided on licensed premises and the responsible health practitioner was a doctor. Subsequently, any health practitioner with abortion in their scope of practice can provide abortion care. To describe the characteristics of health practitioners who expressed an interest in participating in second trimester abortion care, and to identify and describe the barriers to providing an optimal second trimester abortion service. This was an exponential non-discriminating snowball email survey using tick boxes and open comments. Quantitative data were analysed using descriptive statistics and free-text components were analysed using a general inductive approach. The 113 respondents included: 38 hospital-based obstetrics and gynaecology doctors, 22 primary care doctors, 13 midwives and 14 nurses/nurse practitioners. Thirty-three (29.2%) and 62 (54.9%) respondents reported interest in providing second trimester surgical and medical abortion care respectively. The most commonly identified barrier to both surgical and medical second trimester abortion provision was lack of trained staff, followed by an unsupportive work environment. Thematic analysis aligned with these findings and commonly featured difficulty in accessing feticide. We need to actively recruit and train all health practitioners interested in providing second trimester abortion care to strengthen the workforce. This requires an organisation to oversee an inclusive national framework for abortion training, including feticide, and provide professional supervision.

Characteristics and Scoring Model of COVID-19 Severity Predictor in Obstetric and Gynecology Doctors in Indonesia

Background: Obstetrician and gynecologist are one of the contributors in patient care who are susceptible to contracting coronavirus-19 infection. Emergency measures for maternal field are high, while gold standard examination for COVID-19 takes long time with false negative rate. The case fatality rate of COVID-19 among health workers in Indonesia is reported to be high. We want to know epidemiological, clinical, and occupational characteristics of various degrees of COVID-19 severity and create scoring model to predict COVID-19 severity in ob/gyn doctors in Indonesia. Method: This is a descriptive analytic study using a cross-sectional approach. Consecutive sampling was taken from ob/gyn doctors infected with COVID-19 and analyses used were Chi-Square and Mann-Whitney U tests. A scoring model is created and using receiver operating characteristic (ROC) curves, to determine the predictive ability of the scoring model and the cutoff value to COVID-19 severity, then tested for sensitivity and specificity. Result: The mean age of the respondents was 38.2 ± 9.8 and 48.7% were male. Sixty-one percent respondents experienced mild symptoms, infected while on duty (46.1%), and 59% had nuclear family member infected with COVID-19. Age group ([Formula: see text] = 0.000), number of infection ([Formula: see text] = 0.000), vaccination status ([Formula: see text] = 0.010), comorbidities ([Formula: see text] = 0.023), and working hours ([Formula: see text] = 0.002) were significantly different on the COVID-19 severity. Area-under-curve of scoring model was 75.2% and 93.4%. The cutoff value was 10.5 points for between asymptomatic and mild degree (sensitivity 54.2% and specificity 77.8%) and 12.5 points between mild and moderate degree (sensitivity 83.3% and specificity 95.8%) respectively. Conclusion: The developed scoring model can facilitate prediction of COVID-19 severity in ob/gyn doctors, with asymptomatic (score of < 10.5 points), mild degree (score of 10.5–12.5 points), and moderate degree (score of > 12.5 points).

Understanding the opinion of doctors on obstetric violence in Brazil to improve women's care

Background: Disrespect and mistreatment in childbirth are human rights violations and must be understood by everyone. However, there are many controversies in the use of the term 'obstetric violence' in Brazil. Objectives: To understand the opinion of residents and specialist doctors about obstetric violence and get a balanced view to improve women's care. Setting: Public university hospital in São Paulo, Brazil. Participants: Residents in training and specialist doctors in obstetrics and gynecology. Measurements: Participants answered an electronic form on obstetric violence opinions. Findings: Of the 60 participants, 33(45%) were specialist doctors and 27(55%) were medical residents in training. Most interviewees (60%) do not agree with the use of the term “obstetric violence” to define mistreatment and disrespectful treatment of women. Regarding situations that characterize obstetric violence, the percentage of residents who agree with the following statements as forms of obstetric violence was significantly (p<0.05) higher than the specialists in the following aspects: episiotomy without consent (78% vs. 15%), episiotomy without indication (100% vs. 64%), episiotomy without anesthesia (96% vs. 76%), not allowing a companion during childbirth (89% vs. 64%), requiring silence from the birthing woman (100% vs. 73%), undergoing vaginal examinations without consent (85% vs. 58%), not allowing the woman to choose childbirth position (82% vs. 58%) and not allowing breastfeeding in the first hour (82% vs. 58%). Conclusions and implications: The resident doctors in training are aware that the Obstetric Violence typifies the mistreatment and abuse of women during childbirth and the same is not true for specialists. Specialist doctors who completed their training longer ago should undergo training programs for a better understanding of Obstetric Violence.

Perceptions and Knowledge of Women Regarding Contraception and Current Trends in Contraceptive Use in Korea.

This study aimed to investigate the perceptions and behaviors of Korean women of reproductive age in regards to contraception counseling. The study sample was collected in Korea and comprised 1011 women aged 20-44 years and 150 obstetrics and gynecology (OB/GYN) doctors. Participants completed online questionnaires assessing their current methods of contraception, knowledge of and satisfaction with contraceptive methods, and willingness to learn about and use other contraceptive methods. Women used condoms (74.2%), natural methods (cycle control or withdrawal, 52.4%), and combined oral contraceptives (COCs) (36.9%) more frequently than long-acting reversible contraception (LARC) methods, such as hormone-releasing intrauterine system (IUS) (4.5%), copper-intrauterine devices (3.3%), and subdermal implants (1.4%). Although the proportion of women who used LARC was low, those who used hormone-releasing IUS or subdermal implants reported high levels of satisfaction. The findings revealed discordant results between women and OB/GYN doctors regarding the initiation and quality of information provided by doctors about contraception and overall satisfaction with counseling. Most women (83.1%) expressed a desire to have more information about various contraceptive methods. More than 60% of women reported a willingness to use LARC, such as hormone-releasing IUS or subdermal implants, when provided with detailed information in counseling. The majority of Korean women are familiar with condoms and natural methods, but lack knowledge about alternative contraceptive methods, including LARC. Women who used LARC reported higher levels of satisfaction than those who used other methods.

Influenza vaccination during pregnancy and influencing factors in Korea: A multicenter questionnaire study of pregnant women and obstetrics and gynecology doctors

BackgroundAlthough the World Health Organization and health authorities in most countries recommend that pregnant women receive inactivated influenza virus vaccines, coverage remains low. This study aimed to investigate (1) the proportion of pregnant women who received an influenza vaccination and influencing factors and (2) the proportion of obstetrics and gynecology (OBGYN) doctors who routinely recommend influenza vaccination to pregnant women and influencing factors.MethodsTwo separate, anonymized questionnaires were developed for physicians and pregnant and postpartum women and were distributed to multicenters and clinics in South Korea. The proportions of women who received influenza vaccination during pregnancy and OBGYN doctors who routinely recommend the influenza vaccine to pregnant women were analyzed. Independent influencing factors for both maternal influenza vaccination and OBGYN doctors’ routine recommendations to pregnant women were analyzed using log-binomial regression analysis.ResultsThe proportion of self-reported influenza vaccination during pregnancy among 522 women was 63.2%. Pregnancy-related independent factors influencing maternal influenza vaccination were “(ever) received information about influenza vaccination during pregnancy” (OR 8.9, 95% CI 4.17–19.01), “received vaccine information about from OBGYN doctors” (OR 11.44, 95% CI 5.46–24.00), “information obtained from other sources” (OR 4.38, 95% CI 2.01–9.55), and “second/third trimester” (OR 2.41, 95% CI 1.21–4.82)..Among 372 OBGYN doctors, 76.9% routinely recommended vaccination for pregnant women. Independent factors effecting routine recommendation were “working at a private clinic or hospital” (OR 5.33, 95% CI 2.44–11.65), “awareness of KCDC guidelines” (OR 3.11, 95% CI 1.11–8.73), and “awareness of the 2019 national free influenza vaccination program for pregnant women” (OR 4.88, 95% CI 2.34–10.17). OBGYN doctors most commonly chose ‘guidelines proposed by the government or public health (108, 46%) and academic committees (59, 25%), as a factor which expect to affect the future recommendationConclusionThis study showed that providing information about maternal influenza vaccination, especially by OBGYN doctors, is crucial for increasing vaccination coverage in pregnant women. Closer cooperation between the government and OBGYN academic societies to educate OBGYN doctors might enhance routine recommendations.

How the SARS-CoV-2 Pandemic Period Influenced the Health Status and Determined Changes in Professional Practice among Obstetrics and Gynecology Doctors in Romania.

Background and Objectives: The beginning of the SARS-Cov-2 pandemic period has had a strong impact on patients’ life, but also on doctors. The main goal of this research is to identify the difficulties related to the professional activity and personal life of obstetrics and gynecology doctors. Material and Methods: In total, 94 physicians from a single university center answered to an online questionnaire. Socio-demographic, health, family, and job-related data were collected. Data were processed using SPSS (v.25). Results: 7.4% of the doctors were confirmed infected with SARS-Cov-2 during the first 6 months of the pandemic, and 48.94% treated infected patients. Due to the large number of patients, 10.64% of the doctors have had no days-off during the last 6 months, and 22.34% of them have had new medical problems that led them to see a specialist. Seventeen to nineteen percent mentioned an increasing number of working hours and shifts per month due to the pandemic period, more than 10% used pills to cope with work-stress, and 25% of them had sleep disorders along with appetite loss. Extra-protection rules and negative consequences of wearing special equipment were identified: thermal discomfort that caused decreasing resistance and concentration during the surgery (52%), reduced mobility and accuracy of surgical or medical gestures (40%), and intraoperative visibility (47%). Doctors who were working with confirmed pregnant women preferred caesarean section. Conclusions: Working under the stress of an infection with SARS-Cov-2 is causing a lot of pressure and determines changes in personal, familial, social, and professional life. Understanding the challenges that ob-gyn doctors are facing will help institutions to better provide support.

A cross-sectional study of risk factors for postpartum depression

Background Postpartum depression (PPD) is found across the globe, with rates varying from 11 to 42%. Several key risk factors have been identified as major contributors to the development of PPD.Objective The aim of the present study was to assess the sociodemographic and clinical characteristics of PPD and to delineate risk factors for PPD to guard against recurrence and to get a hope for prophylaxis.Patients and methods In this cross-sectional study, 60 PPD females were diagnosed from among 230 Arabic-speaking consenting consecutive postpartum females who were referred from Department of Obstetrics and Gynecology at the Maternity and Child Hospital at Al Medina Al Monawara (Kingdom Saudi Arabia), from January 2015 to June 2015 and underwent complete psychiatric examination with stress upon demographic data and clinical characteristics of the patient using the Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text revision classification. Obstetric case sheets were prepared and psychometric studies were carried out using an Arabic version of the Edinburgh postnatal depression scale, life event questionnaire, and social class study.Results In the current study PPD was diagnosed in 60 out of 230 (26%) postpartum females with a mean score of Edinburgh postnatal depression scale of 13.4±2.3 between the first and second months postpartum in 53.3%, was more common in the young age group, with a past history of psychiatric illness, was more prevalent in rural areas with low social class and social support, more in those with unwanted pregnancies and difficult labor and puerperium. PPD was precipitated by various stressors.Conclusion The current study revealed many risk factors contributing to PPD among females at Al medina Al Monawara, Kingdom Saudi Arabia.Recommendation Encouraging the liaison link between the psychiatric and obstetrics and gynecology doctors together with social workers could help in guarding against recurrence and to get a hope for prophylaxis.

Mental health amongst obstetrics and gynaecology doctors during the COVID-19 pandemic: Results of a UK-wide study

ObjectiveTo explore the impact of the COVID-19 pandemic on the mental health of Obstetricians and Gynaecologists. Study designA cross-section survey-based study amongst doctors working within Obstetrics and Gynaecology in the United Kingdom. ResultsA total of 207 doctors completed the survey. Obstetricians and Gynaecologists reported significantly higher rates of both Major Depressive Disorder (versus, p = 0.023) and Generalised Anxiety Disorder (versus, p = 0.044) as compared to the UK-wide estimates. Sub-group analysis showed that anxiety was more common amongst female doctors as compared to males (versus, p = 0.047). Although the prevalence of GAD was higher amongst registrars compared to their Consultant and/or Senior House Officer counterparts, this was not statistically significant.Respondents felt that the most significant factor for work-related changes to mental health was keeping up to date with frequently changing guidelines and protocols related to COVID-19. Only of respondents felt able to talk to colleagues about their mental health. ConclusionsKey findings include the high prevalence of mental health conditions amongst doctors, demonstration of the persistent taboo that mental health carries within the speciality and the key contributory factors to poor mental health.Further work should be done to assess if changes to the way new and updating guidelines, protocols and pathways are disseminated reduces the impact on the mental health of doctors. With the threat of a second COVID-19 peak looming, now more than ever, it is vital that steps are taken to break the stigmatisation of mental health amongst doctors, encouraging doctors to seek help when required.

The work and training situation for young physicians undergoing specialty training in gynecology and obstetrics in Germany: an assessment of the status quo

PurposeGeneral conditions in the health-care system in Germany have changed dramatically in recent years. Factors affecting this include above all demographic change, rapid developments in diagnostic and therapeutic options, and the application of economic criteria to the health-care sector. This study aimed to establish the current status quo regarding conditions of work and training for young doctors in gynecology and obstetrics, analyze stress factors, and suggest potential improvements.MethodsBetween October 2015 and March 2016, a web-based survey was carried out among residents and members of the German Society for Gynecology and Obstetrics. The electronic questionnaire comprised 65 items on seven topics. Part of the survey included the short version of a validated model of professional gratification crises for analyzing psychosocial work-related stress.ResultsThe analysis included a total of 391 complete datasets. Considerable negative findings in relation to psychosocial work pressure, time and organizational factors, quality of specialty training, and compatibility between work and family life and work and academic tasks were detected. A high level of psychosocial work pressure is associated with more frequent job changes, reduced working hours, poorer health among physicians, and a lower subjectively assessed quality of care.ConclusionsGreater efforts are needed from all the participants involved in patient care to achieve high-quality training and working conditions that allow physicians to work in a healthy and effective way. These aspects are all prerequisites for sustainably maximizing the resource “physician” and for ensuring high-quality patient care.

Post-traumatic stress disorder in obstetrics and gynaecology doctors.

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Work-related post-traumatic stress symptoms in obstetricians and gynaecologists: findings from INDIGO, a mixed-methods study with a cross-sectional survey and in-depth interviews.

To explore obstetricians' and gynaecologists' experiences of work-related traumatic events, to measure the prevalence and predictors of post-traumatic stress disorder (PTSD), any impacts on personal and professional lives, and any support needs. Mixed methods: cross-sectional survey and in-depth interviews. Fellows, members and trainees of the Royal College of Obstetricians and Gynaecologists (RCOG). A survey was sent to 6300 fellows, members and trainees of RCOG. 1095 people responded. Then 43 in-depth interviews with trauma-exposed participants were completed and analysed by template analysis. Exposure to traumatic work-related events and PTSD, personal and professional impacts, and whether there was any need for support. Interviews explored the impact of trauma, what helped or hindered psychological recovery, and any assistance wanted. Two-thirds reported exposure to traumatic work-related events. Of these, 18% of both consultants and trainees reported clinically significant PTSD symptoms. Staff of black or minority ethnicity were at increased risk of PTSD. Clinically significant PTSD symptoms were associated with lower job satisfaction, emotional exhaustion and depersonalisation. Organisational impacts included sick leave, and 'seriously considering leaving the profession'. 91% wanted a system of care. The culture in obstetrics and gynaecology was identified as a barrier to trauma support. A strategy to manage the impact of work-place trauma is proposed. Exposure to work-related trauma is a feature of the experience of obstetricians and gynaecologists. Some will suffer PTSD with high personal, professional and organisational impacts. A system of care is needed. 18% of obstetrics and gynaecology doctors experience post-traumatic stress disorder after traumatic events at work.

Designing meditation for doctor well-being: can 'Om' help obstetrics and gynaecology doctors?

The study aimed to measure the impact of meditation on participants' ability to regulate brain wave activity in high-stress situations, control physiological stress responses and improve subjective wellbeing. Twelve obstetrics and gynaecology (O&G) doctors meditated for 20 minutes daily for 21 days utilising a portable EEG (electroencephalogram) providing instantaneous audio feedback. Their brain activity levels and salivary cortisol were measured before and after performing three surgical procedures. Participants were interviewed about their experiences and completed self-ratings of distress (e.g. DASS-21, Depression, Anxiety and Depression Scale). Data were analysed statistically and thematically. (a) Measures of pre- and post-operative brain activity showed no significantly higher levels of alpha waves. (b) Pre- and post-operative salivary cortisol levels did not significantly decrease. (c) DASS-21 scores showed significant decreases in levels of anxiety and stress. Results suggest that, with biofeedback meditation, O&G doctors can learn to reduce situational stress and improve mood overall through a focussed intervention.

Doctor and patient awareness of treatment options for cervical intraepithelial neoplasia 1 (CIN 1): a survey questionnaire approach

The purpose of this study was to investigate doctors’ and patients’ perceptions of cervical intraepithelial neoplasia 1 (CIN 1) and its treatment methods. A survey questionnaire was offered to obstetrics and gynaecology doctors and patients with CIN 1 in 2017. Only 43% of patients knew of this disease. Regarding perceptions of its aetiology, 64% of the patients perceived human papillomavirus infection to be the main cause of CIN 1. Patients’ most preferred treatments were medication (20%), followed by alternative treatment (14%). Among doctors, regular follow-up was the most preferred method for managing CIN 1. The survey showed that current treatment modalities for CIN 1 were satisfactory to only half of doctors (50%) and patients (53%). Overall, 70% of doctors responded that new drug development for CIN 1 is needed. Although, CIN 1 is a low-grade lesion, doctors and patients expressed the desire for new therapeutic agents to manage it.IMPACT STATEMENTWhat is already known on this subject? In general, treatment is not recommended for CIN 1 because lesions are considered indicative of transient HPV infection and spontaneously regress in most patients.What do the results of this study add? Regular follow-up for CIN 1 were satisfactory to only half of doctors and patients. Thirty-six percent of patients wanted active treatment instead of regular follow-up. In addition, 70% of doctors responded that new drug development for CIN 1 is needed.What are the implications of these findings for clinical practice and/or further research? Our results support the need for therapeutic agents for CIN 1.

Development and Evaluation of Empowering Education Program for Maternal Fetal Intensive Care Unit (MFICU) Nurses.

This study was conducted to develop an empowering education program for Maternal-Fetal Intensive Care Unit (MFICU) nurses who provide intensive care to high-risk mother and fetus at hospitals, to test effects of the education program on nursing care confidence and nursing knowledge, and to examine program satisfaction. This study comprised of 2 phases: program development and evaluation. First, we have followed a process of program development to develop and refine an empowering education program for MFICU nurses through collaborative works among clinical obstetrics and gynecology doctors and nurses and academic nursing professors. Second, the empowering education program was provided to 49 nurses and evaluated from July 5 to 6, 2019. Levels of MFICU nursing care confidence and knowledge were measured. The empowering education program included 18 hours of lectures, discussion, and Q & A, which continued for 2 days. This program significantly improved high-risk maternal-fetal nursing care confidence and knowledge of nurses. The program was well met with nurses' education need and goals, and found to be highly satisfactory. The empowering education program was observed to be effective in terms of improve nursing care confidence and knowledge of nurses in MFICU. It is proposed that this program should be open regularly for nurses to obtain and improve their clinical knowledge, confidence, and competency. Further study is needed to develop and run 2-levels of education such as basic and advanced levels based on nurses' clinical background and competency.